Identifier: breastitsanomali00deav (find matches)
Title: The breast: its anomalies, its diseases, and their treatment
Year: 1917 (1910s)
Authors: Deaver, John B. (John Blair), 1855-1931
Subjects: Breast Breast X-rays Breast Diseases Breast Neoplasms Radiotherapy
Publisher: Philadelphia, P. Blakiston's Son & Co
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons

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lar nodes of the deep cervical chain. Somemammary trunks seem to cross from one side of the chest to the other, thus creating ananastomosis between the two sets of mammary lymph vessels. SURGICAL ANATOMY OF THE BREAST 39 Olsner and Roeffel have demonstrated the existence of a lymphatic trunk that arisesin the lower inner quadrant of one breast and goes directly to the lymph nodes of theopposite axilla. The central cutaneous lymphatics begin in a fine network, beneath the areola, andnipple, and unite into several trunklets. These latter break up to form the sub-areolarplexus of Sappey in which a majority of the glandular lymphatics terminate. The latterarise as sacs in the peri-lobular tissue and form channels which course through the peri-ductal tissue to reach the sub-areolar plexus. Accessory lymph channels emerge from the periphery of the organ and go either tothe axillary, subclavian or internal mammary (retro-sternal) groups of nodes. Several Stemat ^^a^ids---- Int. mammarycfiain
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usc.phrenic Sheath of rectus Fig. 20.—Internal mammary chain of lymphatics. (Leaf.) of these accessory channels detach themselves from the inferior part of the mamma andgo directly to the axilla. Grossman found, in 10 per cent, of the cases studied, a lymphatic trunk that arosefrom the undersurface of the breast, perforated the pectoralis major and passed betweenthe two pectoral muscles to the subclavian nodes. A final group of accessory lymphchannels arises from the inner segment of the breast and follows the perforating branchesof the internal mammary artery to the retro-sternal nodes. These trunks are subjectto early senile atrophy, thus explaining the infrequency of the involvement of the retro-sternal lymph nodes in carcinoma of the breast. The lymphatic distribution as given above is founded on anatomical investigation.Clinical and pathological evidence indicates that the dissemination of mammary car-cinoma principally occurs by way of the lymphatics contained in the deep fasc

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